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Trust is essential to ensure functional and sustainable relationships. While theorists and researchers have explored trust in organizational life, 1 and books on the subject are found in business literature, 2,3 relatively little has been published on how trust, or lack of it, affects clinicians' engagement with the health care organization in which they practice.The American Board of Internal Medicine (ABIM) Foundation convened a forum to explore society's trust in medicine and various ways that trust influences behavior within and across health care organizations. 4 The experiences of a sample of attendees confirmed that some clinicians' distrust of the motives, strategy, or accuracy and relevance of data of the systems in which they work contributes to cynicism, disengagement, and absenteeism. Distrust in many organizations is bilateral. Some managers distrust clinicians and tend to announce initiatives or decisions instead of creating opportunities for engagement. This mutual distrust can adversely affect health care system performance and engenders distrust among patients as well as among the health care professionals and organizations charged with caring for them.

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